moving, leaving a practice

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i was very seriously considering closing my practice about a year ago, and going somewhere else/doing something different, because i was living hand to mouth.i carefully evaluated my practice, and made some important discoveries, ie, howmy biller was killing me, how patients came into the practice, how often they returned, how much i was actually getting for each visit, how much time i could afford to do each of the tasks within the practice, what i needed an assistant to do, how much i was spending on supplies, IT, IT support, what IT was/wasn't doing for me, what i needed my emr to do, and whether the commute was worth it, all on top of a poor social situation, being fifty and alone.i found that i wasn't doing things in the most efficient manner, and there were some things i could change, others i could not, at least for the time being, and still other changes which would take time.those changes which i could make, i did, and i have had some very

significant results.i always reflect on the old adage i learned from mountain climbing--"no matter where you go, there you are".irrespective of moving, a hard and objective evaluation of one's circumstances, particularly with an eye to one's self-created obstacles (the ones we are often most blind to) is critically important.that doesn't mean one shouldn't move, rather be aware of what you pack in your bags.LLAnnie Skaggs wrote: Hi Kris, I can’t say from experience, but I have been talking to recruiters from NZ for over a year now, and I don’t think it is that hard. They are very eager to bring in primary care docs and say they will smooth over all the arrangements. Are you thinking of a temporary or permanent move? As anyone on this list knows, I am in a very tough market and should leave. It appears that there are many parts of the US where I could do better financially than I am doing here. But, again, as everyone knows, I HATE the thought of leaving. I came to Lexington for med school, in large part,

because I want to live here. I love the Bluegrass…the horse industry, the Ky Horse Park, Keeneland… so I keep hanging on. BUT, in 2006, at a moment when I was really down and thinking I was going to be forced to give up and go, I got a mailing from a NZ recruiter…. It got me thinking: If I HAVE to leave, then I should at least make sure I go someplace REALLY COOL, and NZ certainly seems to meet that criteria. Other than medicine, which I love, my passions are horses, skiing, and snorkeling, and NZ has all those, in spades. In particular, there is a very vibrant horse community and many, many great horses and places to ride them. The weather is great, year round…. Last year I read several books by US ex-pats living

there, and learned nothing to make me think I would anything but love it there. It’s a big move, particularly if I take my horse (costs about $5K to ship a horse there, and it’s not a risk free proposition), and if I went it would be with the intention of never coming back. Things holding me back at this point are: 1) inertia. I admit it, part of not moving is that it’s just a lot of effort. 2)hubbie’s practice is very specialized and not that portable. It has taken him a long time to build up here, and moving would probably just

push him into semi retirement. 3) World Equestrian Games. In 2010, the WEG will be held here in Lexington; the first time it will ever be held outside Europe. From the first conversations with NZ I have held that if I can hang on here until then, I would, so I can be here for that. So, I am in a holding pattern, but will be actively considering more as 2010 approaches. The one thing I have NOT been able to do is connect with a doctor who is actually practicing there, to see what their complaints are. It seems NZ has a sort of hybrid system with state support AND private insurance. As best I have been able to gather, it doesn’t look like the private insurance industry is running as rough-shod over doctors as ours do, but I want to hear that

from the front lines before I make any commitments. Anyway, what are you thinking? If you love the outdoors, NZ looks hard to beat! Annie From: [mailto: ] On Behalf Of mkcl6@... Sent: Monday, December 31, 2007 7:17 AM To:

Subject: Re: Re: alternatives to Instant medical history How hard is it for an American doctor to get a license in New Zealand? seriously. Kris See AOL's top rated recipes and easy ways to stay in shape for winter.

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